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Improving Psychotherapeutic Medication Prescribing in Florida: Implementation of the Florida Medicaid Drug Therapy Management Program (MDTMP)

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Abstract

This paper describes a program that was established by Florida Medicaid to improve the quality of prescribing of psychotherapeutic medications. It relates the process used for defining quality medication treatment including the definitions of unusual psychotherapeutic medication indicators (UPMI). It details the results of analysis of FY 2007–2008 pharmacy claims data using these indicators that enabled the Program to identify practices and prescribers that required targeted interventions. The most frequently triggered UPMI for adults involved the use of 2 or more antipsychotics for greater than 60 days; high doses of psychotherapeutic medications was the indicator most frequently triggered for children closely followed by the use of 2 or more antipsychotics for more than 45 days. Prescriptions that triggered UPMI were concentrated in a small number of prescribers. These results led to the Program focusing on these high frequency practices and on the prescribers most associated with them. They also led to the implementation of new quality improvement initiatives like the implementation of a psychiatric telephone consultation line for pediatricians who are treating children with serious emotional disturbances who do not have access to child psychiatrists.

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Acknowledgments

This research was supported by Contract No. MED112 from the State of Florida Agency for Health Care Administration.

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Authors and Affiliations

  1. Florida Mental Health Institute, University of South Florida, 13301 Bruce B. Downs Blvd, MHC 2724, Tampa, FL, 33612, USA

    Robert J. Constantine & Marie A. McPherson

  2. Medicaid Pharmacy Services, Agency for Health Care Administration, Tallahassee, FL, USA

    Mary Elizabeth Jones

  3. Department of Psychiatry, University of Florida, Gainesville, FL, USA

    Rajiv Tandon

  4. Department of Health Policy and Management, Emory University, Druid Hills, GA, USA

    Edmund R. Becker

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  1. Robert J. Constantine
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  2. Marie A. McPherson
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  3. Mary Elizabeth Jones
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  4. Rajiv Tandon
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Correspondence to Robert J. Constantine.

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Constantine, R.J., McPherson, M.A., Jones, M.E. et al. Improving Psychotherapeutic Medication Prescribing in Florida: Implementation of the Florida Medicaid Drug Therapy Management Program (MDTMP). Community Ment Health J 49, 33–44 (2013). https://doi.org/10.1007/s10597-012-9497-y

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